title: Increased morbidity in surgical patients undergoing secondary (incidental) cholecystectomy.
abstract: Using computerized hospital discharge abstracts for all Vermont residents hospitalized during 1983 and 1984, we examined the question of whether increased morbidity occurs in patients undergoing secondary (incidental) cholecystectomy. Among a cohort of 4183 patients undergoing a primary surgical procedure in which secondary cholecystectomy might have been considered. 69 patients had a secondary cholecystectomy. The surgical wound infection rate was 8.7% in the secondary cholecystectomy group compared to 2.4% in the rest of the cohort (relative risk, 3.7, 95% C.I. 1.7, 8.1). Other postoperative complications occurred in 10.1% of those undergoing secondary cholecystectomy compared to 4.1% in those who did not (relative risk, 2.5, 95% C.I. 1.2, 5.1). The adjusted relative risk for wound infection was 3.3 (95% C.I. 1.4,8.0) and for other surgical complications was 1.7 (95% C.I. 0.8, 3.8). Postoperative length of hospital stay was longer for the secondary cholecystectomy group (mean, 13.8 days) than in the comparison group (mean 8.9 days, p = 0.001). These data suggest that patients undergoing a secondary cholecystectomy may have an increased risk of surgical wound infection and possibly other surgical complications.
authors.affiliation: Nassau County Medical Center, East Meadow, New York 11554.
authors.forename: J D
authors.initials: JD
authors.lastname: Green
authors.forename: G
authors.initials: G
authors.lastname: Birkhead
authors.forename: J
authors.initials: J
authors.lastname: Hebert
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.forename: R L
authors.initials: RL
authors.lastname: Vogt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002763:Cholecystectomy / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012306:Risk; D013530:Surgical Wound Infection / Q000453:epidemiology